| NPI | 1558742585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY MONIQUE WATERS Owner 225-775-9406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-01-22 |